摘要
目的比较不同Narcotrend指数(NTI)下全麻患者诱导期气管插管的应激反应。方法选择60例ASAⅠ~Ⅱ级气管插管全麻患者,按照数字表法随机分为两组:浅麻醉组(NL组)和深麻醉组(ND组),每组各30例。NL组患者麻醉诱导时NTI控制在64~37范围内,相应麻醉深度级别(NTS)为D0~D2;ND组患者麻醉诱导时NTI控制在36~13范围内,相应NTS为E0~E2。记录麻醉麻醉诱导前(T0)、气管插管前(T1)、气管插管后1 min(T2)、3 min(T3)、5 min(T4)的心率(HR)、收缩压(SBP)、舒张压(DBP)及NTI值。气管插管后SBP或HR升高幅度大于基础值20%以上认定为发生心血管反应,记录心血管反应发生情况。结果两组患者T0时HR、SBP、DBP比较差异无统计学意义(P>0.05)。ND组T1~T4时HR、SBP、DBP比T0时下降(P<0.05);NL组T1时HR、SBP、DBP比T0时降低(P<0.05),T2~T3时HR、SBP、DBP比T0时增快或升高(P<0.05);NL组T2~T4时HR、SBP、DBP比ND组增快或升高(P<0.05)。NL组心血管反应发生率为60%,ND组无心血管反应发生,差异有统计学意义(P<0.05)。结论Narcotrend监测下的深麻醉状态,能有效减轻气管插管引起的机体应激反应,维持血流动力学平稳。
Objective To compare the stress responses of tracheal intubation during induction of general anesthesia in patients with different narcotrend index(NTI).Methods Sixty patients ASA physical statusⅠ~Ⅱwith endotracheal intubation under general anesthesia,in accordance with the random number table method were randomly divided into two groups with 30 cases each:lighter anesthesia group(group NL)and deeper anesthesia group(group ND).NTI in group NL was controlled within the range of 64~37,and the corresponding level of anesthesia depth Narcotrend stage(NTS):D0~D2;NTI in Group ND was controlled within the range of 36~13,and NTS:E0~E2.Heart rate(HR),Systolic blood pressure(SBP),Diastolic blood pressure(DBP)and NTI were measured before induction(T0),before tracheal intubation(T1),and at 1 min(T2)、3 min(T3)、5min(T4)after intubation.It was identified as cardiovascular reaction,when SBP or HR after tracheal intubation increased by more than 20%of the basal value,then record the occurrence of cardiovascular reaction.Results There were no significant difference in HR、SBP and DBP at T0 time point between two groups(P>0.05).HR、SBP and DBP at T1~T4 were lower than those at T0 in group ND(P<0.05).HR、SBP and DBP at T1 were lower than those at T0(P<0.05),and were higher at T2~T3 than those at T0 in group NL(P<0.05).HR、SBP and DBP at T2~T4 were higher in group NL than those in group ND(P<0.05).The incidence of cardiovascular disease was 60%in group NL and no cardiovascular reaction occurred in group ND(P<0.05).Conclusion Maintaining the deep anesthesia guided by Narcotrend could be more effectively attenuate the stress reaction caused by tracheal intubation,and maintain the stability of hemodynamic during anesthesia induction.
作者
李秀丽
刘晓芳
冯宇峰
LI Xiuli;LIU Xiaofang;FENG Yufeng(Deparment of Anesthesiology,Pengzhou People’s Hospital,Chengdu Sichuan 611900,China;Department of Anesthesiology,Xiamen Maternal and Children Hospital,Xiamen Fujian 361003,China;Deparment ofAnesthesiology,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China)
出处
《中国卫生标准管理》
2019年第24期124-126,共3页
China Health Standard Management